RECRUITING

Treatment of Systemic Lupus Erythematosus (SLE) With N-acetylcysteine

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease which often has debilitating and potentially life-threatening consequences. The cause of SLE is unknown and current therapies lack specificity and carry significant side-effects. We previously discovered the depletion of glutathione in lymphocytes of patients with SLE and associated this metabolic change with the elevation of the mitochondrial transmembrane potential. This study will titrate to tolerance during an initial 3 month open label period and then subjects will be randomized to one of 2 arms. It was determined by statistical analysis that each group must have 105 subjects. All subjects will be enrolled and evaluated for tolerance of NAC between dosages of 2.4 g/day and 4.8 g/day for 3 months. After A 3-month open-label dose-titration phase, SLE subjects will be randomized into 2 groups of 105 subjects either to continue the tolerated dosage of NAC or switched to equal number of placebo capsules. There will be up to seven study visits per SLE subject, including the screening and wash out visits. Visits 2-6 will be scheduled three months apart. The study will last 13 months with the wash-out visit. Each subject will donate approximately 100 ml of blood for biomarker studies at each visit. Healthy control subjects will donate blood at the same time. They will be matched to the SLE subjects by gender, age within 10 years, and ethnicity. Their blood will be used as reference for biomarker assays. There is a consent form required to participate in the phase II study.

Official Title

Treatment of Systemic Lupus Erythematosus (SLE) With N-acetylcysteine (NAC) (SNAC)

Quick Facts

Study Start:2022-05-05
Study Completion:2028-09-30
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT00775476

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:Yes
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * Age ≥ 18;
  2. * Male or female;
  3. * ≥ 4 ACR SLE classification criteria (104,105);
  4. * Positive ANA at a titer of ≥ 1/80;
  5. * Stable immunosuppressants (MMF ≤ 3 g/day, azathioprine ≤ 150 mg/day; methotrexate ≤ 25 mg/week; leflunomide ≤ 20 mg/week; cyclosporin 100 mg/day; voclosporin 47.4 mg/day) and/or antimalarials (hydroxychloroquine ≤ 400 mg/day) for 30 days prior to screening; stable oral corticosteroids for 2 weeks prior to screening; ≤ 20 mg/day prednisone or equivalent; stable belimumab or anifrolumab for 90 days prior to screening;
  6. * BILAG 2004 index (48) level A disease activity in ≥ 1 organ/system except renal or central nervous system or BILAG 2004 index level B disease activity in ≥ 1 organs/systems if no level A disease activity is present and SLEDAI ≥ 6 (106);
  7. * Enrollment is approved by adjudication committee within 10 days, which may include retesting and communication with study sites, as necessary.
  8. * Patients may be considered for enrollment 12 months after rituximab treatment, or 6 months after rituximab treatment if their B cell counts have normalized.
  9. * Acute SLE flare threatening vital organs;
  10. * Pregnant or lactating;
  11. * Moderately serious or serious comorbidities (e.g., diabetes mellitus, congestive heart failure, chronic obstructive pulmonary disease, chronic renal insufficiency) that in investigator's opinion confers high risk for adverse events;
  12. * Patients receiving cyclophosphamide within 3 months;
  13. * Active chronic infections (e.g., HIV, hepatitis B virus, hepatitis C virus, mycobacteria); patients with oral steroid-dependent asthma;
  14. * Infections requiring intravenous antibiotics within a month or oral antibiotics within two weeks of screening; Patients taking (unwilling or unable to stop) NAC or other antioxidants within 1 month of screening (which is considered sufficient time to revert GSH to pre-treatment levels (29);
  15. * Patients who participated in the pilot RCT or are taking daily acetaminophen (≤ 1 g/day prn is allowed if documented);
  16. * Patients receiving mTOR inhibitors (rapamycin/sirolimus, everolimus);
  17. * Patients enrolled in other interventional trials.
  18. * Patients should not take medications containing acetaminophen (Tylenol) as it may reduce the effectiveness of NAC. 1 g/day of acetaminophen is allowed if documented.
  19. * Patients should avoid taking more than 500 mg of vitamin C and more than 30 IU of vitamin E daily as both vitamin C and E can confound the study results.
  1. Pregnancy or breastfeeding
  2. Severe psychiatric disorders
  3. Active substance abuse
  4. Unstable medical conditions
  5. Inability to comply with study requirements

Contacts and Locations

Study Contact

Andras Perl, M.D., Ph.D.
CONTACT
(315) 464-4194
perla@upstate.edu
FNU Ruchi, M.D.
CONTACT
(315) 464-1779
ruchif@upstate.edu

Principal Investigator

Andras Perl, M.D., Ph.D.
PRINCIPAL_INVESTIGATOR
State University of New York - Upstate Medical University

Study Locations (Sites)

Cedars-Sinai Medical Center
Los Angeles, California, 90048
United States
Yale Center for Clinical Investigation
New Haven, Connecticut, 06519
United States
Hospital for Special Surgery
New York, New York, 10021
United States
SUNY Upstate Medical University
Syracuse, New York, 13210
United States
The Ohio State University
Columbus, Ohio, 43210
United States
VA Medical Center
Oklahoma City, Oklahoma, 73104
United States
St. Luke's University Health Network
Allentown, Pennsylvania, 18102
United States
Penn State MS Hershey Medical Center
Hershey, Pennsylvania, 17033
United States

Collaborators and Investigators

Sponsor: State University of New York - Upstate Medical University

  • Andras Perl, M.D., Ph.D., PRINCIPAL_INVESTIGATOR, State University of New York - Upstate Medical University

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2022-05-05
Study Completion Date2028-09-30

Study Record Updates

Study Start Date2022-05-05
Study Completion Date2028-09-30

Terms related to this study

Keywords Provided by Researchers

  • Systemic lupus erythematosus (SLE), an autoimmune disease

Additional Relevant MeSH Terms

  • Systemic Lupus Erythematosus